Kansas Podiatric Medical Association

March 12, 2019

To: Chairwoman Rep. Brenda Landwehr and Members of the House Health and Human Services Committee State Capitol Building 300 SW 10th Ave. Room 546-S Topeka, Kansas 66612

From: Scott D. McKenzie

Re: SB61 Podiatric Physicians in Kansas

The undersigned is the Executive Secretary of the Kansas Podiatric Medical Association.

In 2014, the Kansas legislature amended K.S.A. 65-2002(d) to require any Doctor of Podiatric Medicine performing rear foot / ankle reconstructive surgery to have completed a three year surgical residency program and be either board certified or progressing towards board certification. The 2014 restrictions apply only to Doctors of Podiatric Medicine. As a result, older and more experienced Doctors of Podiatric Medicine who were trained when residency programs were less than the current three or four year requirement could no longer perform rear foot / ankle reconstruction procedures despite being board certified to perform those procedures. Kansas became the first and only state establishing by statute directives to hospitals and surgical centers specifying which Doctors of Podiatric Medicine may be granted surgical privileges based on a candidates length of residency or board certification. MD and DO orthopedic doctors are not required to be board certified or progressing towards board certification to perform rear foot / ankle procedures.

In the United States, medical and surgical care of the foot and ankle is mainly provided by two groups of professionals: podiatrists (also known as podiatric physician or Doctor of Podiatric Medicine or DPM) and orthopedists (MD’s or DO’s). The difference between the two specialties is that orthopedic doctors specialize in the medical and surgical management of all bones and joints of the entire body while podiatric doctors focus on the foot and ankle. Doctors of Podiatric Medicine are qualified to diagnose and treat conditions affecting the foot, ankle and related structures of the leg and are the only physicians to receive specialized medical training and board certification solely in the care of the foot and ankle. American Doctors of podiatric medicine have a four year bachelors degree (typically in life sciences) followed by a four year medical degree (DPM). Following medical school, Doctors of Podiatric Medicine now complete a three or four year surgical residency program. The Counsel on Podiatric Medical Education serves as the accrediting agency in the profession of podiatric medicine. The Counsel evaluates, approves, and accredits educational and institutional programs throughout the United States, its territories, and Canada. Podiatrist are licensed to practice in all 50 states, but each state has its own licensing requirements.

KPMA Executive Office: 1603 SW 37th Street Topeka, Kansas 66611-2645 Telephone: (785) 267-5400 Most states now require Doctors of Podiatric Medicine to have completed a four year medical degree and a two year residency.

Doctors of Podiatric Medicine may be certified for the specialty areas of podiatric orthopedics and primary podiatric medicine by the American Board of Podiatric Medicine. Doctors of Podiatric Medicine may also be certified for the specialty area of podiatric surgery by the American Board of Foot and Ankle Surgery. Board certification is a minimum five year process requiring completion of at least a 24 month residency program, successful completion of a two part examination process plus successfully performing specified numbers of surgical and medical procedures.

Because of the 2014 Kansas amendments, older and more experienced Doctors of Podiatric Medicine (with less than a three year residency when trained) and their Kansas patients are required to cross state lines to utilize hospitals and surgical centers outside of Kansas to perform these procedures. Likewise, well qualified out of state DPM’s licensed in Kansas can no longer perform these medical procedures at a Kansas hospital or surgical center.

SB61 is an attempt to address this issue. The language is a compromise arrived at after discussions between members of the Kansas Podiatric Medical Association and other healthcare providers. SB61 retains the requirement that Doctors of Podiatric Medicine performing rear foot /ankle procedures be board certified or progressing towards board certification. If approved and signed into law, SB61 would once again allow Doctors of Podiatric Medicine who prior to 2007 completed a 24 month surgical residency and are board certified or progressing towards board certification to once again perform rear foot / ankle medical procedures.

On behalf of the Kansas Podiatric Medical Association, we urge committee approval of SB61.

Respectfully,

/s/ Scott D. McKenzie Executive Secretary

SDM/sgm

2